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ICD-10 Guide
ICD-10 CodesS52.099

S52.099

Billable

Other fracture of upper end of unspecified ulna

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/24/2025

Code Description

ICD-10 S52.099 is a billable code used to indicate a diagnosis of other fracture of upper end of unspecified ulna.

Key Diagnostic Point:

The S52.099 code refers to fractures occurring at the upper end of the ulna, which is a critical bone in the forearm that plays a significant role in elbow stability and function. These fractures can result from various mechanisms, including falls, direct trauma, or sports injuries. The upper end of the ulna articulates with the humerus at the elbow joint, making these fractures particularly relevant in the context of elbow injuries. Symptoms typically include pain, swelling, and limited range of motion in the elbow. Complications may arise, such as compartment syndrome, which can occur due to increased pressure within the muscle compartments of the forearm, leading to muscle and nerve damage if not addressed promptly. Treatment often involves orthopedic fixation procedures, which may include the use of plates, screws, or intramedullary nails to stabilize the fracture and promote healing. Accurate coding is essential for proper reimbursement and to ensure that the patient's medical record reflects the complexity of their injury and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Potential for associated injuries (e.g., radius fractures)
  • Need for detailed documentation of treatment procedures
  • Differentiation from similar codes for specific fracture types

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to document associated injuries
  • Lack of clarity on treatment procedures performed
  • Misuse of unspecified codes leading to denials

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes are essential to support the diagnosis and treatment.

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or motor vehicle accidents.

Billing Considerations

Ensure that all associated injuries are documented, and the rationale for surgical intervention is clear.

Emergency Medicine

Documentation Requirements

Accurate initial assessment notes, imaging results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with acute elbow pain and swelling after trauma.

Billing Considerations

Document the mechanism of injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S52.099 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used appropriately for fractures not specified as open or closed
  • Include additional codes for any associated injuries or complications

Exclusion Criteria

Do NOT use S52.099 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24500CPT Code

Open treatment of fracture of ulna

Clinical Scenario

Used when surgical fixation is performed for an upper end ulna fracture.

Documentation Requirements

Operative report detailing the procedure, fixation method, and post-operative care.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and fixation technique.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data for treatment and outcomes. S52.099 provides a clear designation for unspecified ulna fractures, aiding in better tracking and management of these injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data for treatment and outcomes. S52.099 provides a clear designation for unspecified ulna fractures, aiding in better tracking and management of these injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data for treatment and outcomes. S52.099 provides a clear designation for unspecified ulna fractures, aiding in better tracking and management of these injuries.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding S52.099 accurately?

Accurate coding of S52.099 is crucial for proper reimbursement, tracking of treatment outcomes, and ensuring that the patient's medical record reflects the complexity of their injury and care provided.